Heart transplant at Saint Thomas a mix of ‘God and science’

During a press conference on Monday, May 23, Saint Thomas Hospital officials introduced Jim Talbott, right, the first patient to receive a heart transplant since the hospital’s heart transplant program was re-launched in April. Talbott suffered a massive heart attack in April. Photo by Andy Telli

Jim Talbot showed up at Saint Thomas Midtown Hospital on April 6 with difficulty breathing. He thought it was a respiratory problem. But it was much worse than that. Talbot was suffering a heart attack.

That trip to the hospital sent Talbot on a journey that led to a heart transplant, the first one performed by doctors at Saint Thomas Health since the transplant program was suspended in 2011.

“The whole thing is surreal,” said Talbot, 42, who was introduced at a press conference on Monday, May 23, along with the doctors and nurses who cared for him. “If you would have told me six months ago, I wouldn’t have believed it.”

“It’s a wonderful time to be at Saint Thomas,” said Dr. Brian Wilcox, the medical director of the Saint Thomas heart care program.

Earlier this year, Saint Thomas brought on Dr. Ashok N. Babu to be the surgical director for the heart transplant program, and in April Saint Thomas received certification to perform heart transplants from the United Network for Organ Sharing.

Babu performed the transplant surgery on Talbott on May 11, six weeks after he first showed up with trouble breathing. “Jim is an incredibly tough patient,” Babu said. “We’re especially proud of his case, especially how he got to a heart transplant.”

Talbot had no previous heart troubles before, which made it difficult to diagnose the heart attack. When one of the cardiologists at Saint Thomas Midtown recognized that Talbot indeed was having a heart attack, he immediately transferred Talbot to Saint Thomas West, Babu explained.

While recovering from the original heart attack, “all of a sudden, his heart stopped,” Babu said.

“I coded for about 45 minutes,” Talbot was told.

He was left with about half of his heart muscle dead, Babu said. “In the past, we couldn’t have saved patients like him.”

Doctors were able to revive Talbot and eventually hooked him up to a temporary device that kept blood pumping through his heart, Babu said.

In that kind of circumstance, doctors typically would have replaced the temporary device with an implantable device, Babu said. But because there was the possibility that even with an implantable device Talbot would need a heart transplant later, it was decided to wait to see if a heart became available, he added.

“The danger is we were gambling on when a heart would become available,” Babu said.

Talbot waited only three days.

No details were released about the donor. “We’re a faith based organization. We always want to acknowledge what someone did” in donating their heart, Wilcox said. “It’s bittersweet. … We’ve kept that family in our prayers.”

Talbot is not permitted to contact the donor’s family directly, but he can write a letter and the family can decide whether to accept it, he explained. He is planning to write a letter of thanks, Talbot said. “I’ve thought about the donor a lot.”

Talbot was a good candidate for a heart transplant because he had no other health problems, Babu said. “We want to see a patient the only thing bad is the heart. His kidneys are good, his lungs are good, he’s in good shape.”

Talbot is a cancer survivor, but that wasn’t a problem because he has been in remission for eight years, Babu said.

“If a patient goes five years without remission of cancer, we consider them clear of the disease,” said Dr. Don Chomsky, part of the transplant team.

Doctors and nurses began preparing Talbot for the transplant surgery about 4:30 a.m. on May 11. The surgery was completed about 12 hours later, Babu said. After the donor heart arrived, it took about 28 minutes to replace the heart and get the blood flowing through it and another 30 minutes to complete sewing all the veins and arteries together, Babu said, who led the surgical team. After that, doctors and nurses were checking the bleeding at the stitches waiting for the blood to clot, he added.

After the surgery, it didn’t take Talbot long to notice the difference. “He was on a pretty strong temporary device” before the transplant, Babu said. After the surgery, Talbot told his doctor, “Wow, it’s a huge difference.”

“It’s hard to replicate the effect of a human heart,” Babu said.

Saint Thomas, which is part of Ascension Health, the largest Catholic healthcare system in the world, in 1985 became the first hospital in Tennessee and the 26th in the United States to establish a heart transplant program. In 2011, the program was suspended after the unexpected loss of key personnel.

The hospital staff spent the time since “thoughtfully considering how to move forward,” Wilcox said. Saint Thomas Heart worked on building the infrastructure of the program, developing its capability to treat patients with heart assist devices, he said.

The goal was always to get back to doing heart transplants, Wilcox said.

During the interim, Saint Thomas Heart patients who needed a transplant would be referred to other facilities, even though many expressed an interest in having the surgery performed at Saint Thomas where they were familiar with the doctors and the facility, he said.

“It’s been difficult for us and our patients,” Chomsky said. Many of Saint Thomas’ patients receive care for heart disease for more than a decade before they get to the point they need a transplant, he said, and transferring to another hospital is not good for the patient.

“We’re really excited that we can offer our patients the full line of heart care,” Wilcox said.

Babu, who came to Saint Thomas from the University of Colorado Hospital in Denver, has performed about 50 heart transplants, he said.

“It’s an amazing thing to be able to do a heart transplant,” he said. “These typically are patients with limited prospects of surviving. A transplant can give them 10, 15, sometimes 30 years of life. There’s not much we can do in the health care field that has that type of result.”

Babu would like to see the Saint Thomas heart transplant program grow to the point where up to 30 transplants are performed there every year, he said.

Talbot, who will be on medication for the rest of his life, hopes eventually to return to his job as an event coordinator at the Nashville City Club. “They’re going to let me know when I can go back,” he said of his doctors.

His survival is the result of a positive attitude “and people’s prayers, too,” said Talbot, who also thanked the many nurses who cared for him.

“It’s a mix of a miracle and science,” his friend Steve Brady said of Talbot’s transplant. “God and science.”